Chronic subdural hematoma, as an initial manifestation of glutaric aciduria type-1

Brain Dev. 1993 Mar-Apr;15(2):125-7. doi: 10.1016/0387-7604(93)90049-e.

Abstract

A 10-month-old male with glutaric aciduria type-1 (GA-1) is reported. This patient showed frequent partial motor seizures, irritability, and involuntary movements, including oral dyskinesia at the age of 3 months. On admission, magnetic resonance (MR) scanning revealed a chronic subdural hematoma and widening of the bilateral insular cisterns. Urine organic acid analysis showed marked excretion of glutaric acid, 3-hydroxy glutaric acid and glutaconic acid, suggesting GA-1. Removal of the subdural hematoma was effective for the irritability but not for the extrapyramidal signs. This is the first report of a subdural hematoma as an initial symptom in a patient with GA-1. However, the complication of subdural fluid collection in GA-1 is not rare. To our knowledge, of 29 patients with GA-1 who underwent computed tomographic or MR scans, 5 had subdural fluid collection. Disproportional hypoplasia of the temporal lobes may be a suggestive etiology of subdural fluid collection/chronic subdural hematoma.

Publication types

  • Case Reports

MeSH terms

  • Amino Acid Metabolism, Inborn Errors / complications*
  • Amino Acid Metabolism, Inborn Errors / diet therapy
  • Amino Acid Metabolism, Inborn Errors / urine
  • Brain / diagnostic imaging
  • Glutarates / metabolism*
  • Glutarates / urine
  • Hematoma, Subdural / diagnostic imaging
  • Hematoma, Subdural / etiology*
  • Humans
  • Infant
  • Male
  • Tomography, X-Ray Computed

Substances

  • Glutarates